Provider Demographics
NPI:1912778986
Name:HINOJOSA, YVETTE R
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:R
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:KS
Mailing Address - Zip Code:66021-2116
Mailing Address - Country:US
Mailing Address - Phone:913-313-9349
Mailing Address - Fax:
Practice Address - Street 1:13628 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1934
Practice Address - Country:US
Practice Address - Phone:319-764-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSMTL23-0157225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist